The nurse is reviewing the prescription for a client with pneumonia. The client's vital signs are: Temperature 101.2°F (oral), BP 100/70, pulse rate 110/min., respirations 22, and oxygen saturation 96%. Based on these findings, which order should the nurse seek clarification for?
A. Schedule client for a chest x-ray.
B. Start oxygen therapy at 3L/minute via nasal cannula.
C. Administer intravenous (IV) fluids: 0.9% Normal Saline Solution at 125 ml/hour.
D. Administer acetaminophen (Tylenol) 650 mg every 4 hours as needed for a temperature greater than 100.5°F.
Answer: B
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The nurse notices that a group member is quiet during support group meetings. What is the best intervention by the nurse for involving the quiet group member in the group process?
a. Ask the group if they have noticed that a group member never talks. b. Ask the group what can be done to involve the quiet group member more. c. Set up a private meeting with the quiet group member to discuss group participation. d. Ask the quiet group member if he or she would like to comment on what another group member has just said.
When caring for client experiencing treatment of substance abuse, the nurse should:
a. maintain a nonjudgmental, positive attitude. b. ensure that the client does not abuse the same substance in the future. c. allow the client to take her prescribed medication on a p.r.n. basis. d. maintain the temperature of the physical environment at less than 70° F.
The nurse is conducting a nursing assessment of the parent and child with severe cerebral palsy during a routine clinic visit. Which nursing action is appropriate based on the current data?
1. Measuring the urine output 2. Measuring the child's head circumference 3. Observing the parent–child relationship 4. Observing how the child interacts during play
What is helpful to tell a mother who is concerned about preventing sleep problems in her 2-year-old child?
a. Have the child always sleep in a quiet, darkened room. b. Provide high-carbohydrate snacks before bedtime. c. Communicate with the child's daytime caregiver about eliminating the afternoon nap. d. Use a night-light in the child's room.